牙周牙髓联合治疗在重度牙周炎患者中的应用效果
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摘要
目的探讨牙周牙髓联合治疗在重度牙周炎患者中的应用效果。方法选取2017年3月～2018年3月我院口腔内科门诊治疗的26例(38颗患牙)重度牙周炎患者作为研究对象,随机分为研究组和对照组,每组各13例(19颗患牙)。研究组采用牙周牙髓联合治疗,对照组采用单纯牙周治疗。随访6个月,比较两组患者治疗后3、6个月的牙周袋探诊深度(PDD)、相对附着水平(RAL)、釉牙骨质界到骨缺陷底的距离(CEJ-BD)、釉牙骨质界到牙槽嵴顶的距离(CEJ-AC)和计算机辅助骨密度影像分析值(CADIA)。结果治疗3、6个月后,两组患者的PPD、RAL、CEJ-BD、和CEJ-AC低于治疗前,CADIA高于治疗前,差异均有统计学意义(P<0.05);治疗3、6个月后,研究组患者的CEJ-BD、和CEJ-AC低于对照组,CADIA高于对照组,差异均有统计学意义(P<0.05)。结论与单纯牙周治疗比较,牙周牙髓联合治疗更有利于骨组织的恢复,治疗效果更好。
Objective To explore the application effect of combined periodontal and pulpal therapy in patients with severe periodontitis. Methods A total of 26 patients(38 offending teeth) with severe periodontitis treated in outpatient department of stomatology in our hospital from March 2017 to March 2018 were randomly divided into study group and control group, with 13 cases(19 offending teeth) in each group. The study group was treated with combined periodontal and pulpal therapy, while the control group was treated with simple periodontal therapy. The patients were followed up for 6 months, the PDD, RAL, CEJ-BD, CEJ-AC and CADIA were compared between the two groups 3 and 6 months after treatment. Results After 3 and 6 months of treatment, PPD, RAL, CEJ-BD and CEJ-AC in the two groups were lower than those before treatment, and CADIA was higher than those before treatment, the differences were statistically significant(P<0.05). After 3 and 6 months of treatment, CEJ-BD, CEJ-AC and CADIA in the study group were lower than those in the control group, and higher than those in the control group, the differences were statistically significant(P<0.05). Conclusion Compared with simple periodontal therapy, combined periodontal and pulpal therapy is more conducive to the recovery of bone tissue and has better therapeutic effect.
Objective To explore the application effect of combined periodontal and pulpal therapy in patients with severe periodontitis. Methods A total of 26 patients(38 offending teeth) with severe periodontitis treated in outpatient department of stomatology in our hospital from March 2017 to March 2018 were randomly divided into study group and control group, with 13 cases(19 offending teeth) in each group. The study group was treated with combined periodontal and pulpal therapy, while the control group was treated with simple periodontal therapy. The patients were followed up for 6 months, the PDD, RAL, CEJ-BD, CEJ-AC and CADIA were compared between the two groups 3 and 6 months after treatment. Results After 3 and 6 months of treatment, PPD, RAL, CEJ-BD and CEJ-AC in the two groups were lower than those before treatment, and CADIA was higher than those before treatment, the differences were statistically significant(P<0.05). After 3 and 6 months of treatment, CEJ-BD, CEJ-AC and CADIA in the study group were lower than those in the control group, and higher than those in the control group, the differences were statistically significant(P<0.05). Conclusion Compared with simple periodontal therapy, combined periodontal and pulpal therapy is more conducive to the recovery of bone tissue and has better therapeutic effect.
引文
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[6]金玥,陈斌,泥艳红,等.牙周来源的牙周牙髓联合病变和牙周牙髓共存病变患牙牙周治疗时机的系统评价[J].华西口腔医学杂志,2018,36(2):167-173.
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[8]Gary C.Armitage,侯建霞.牙周疾病和状况的诊断及分类系统所面临的挑战[J].中华口腔医学杂志,2008,43(5):260-263.
[9]Zehnder M,Gold SI,Hasselgren G.Pathologic interactions in pulpal and periodontal tissues[J].J Clin Periodontol,2010,29(8):663-671.
[10]Gautam S,Galgali SR,Sheethal HS,et al.Pulpal changes associated with advanced periodontal disease:a histopathological study[J].J Oral Maxillofac Pathol,2017,21(1):58-63.
[11]马先庆.根管治疗后继发根尖周炎患者根管内微生物群落的研究[J].医学临床研究,2016,33(3):485-487.
[12]邱小玲,贾搏,韩久松,等.显微根尖手术联合MTA治疗难治性慢性根尖周炎的研究[J].口腔医学研究,2017,33(7):770-773.
[13]王傲晨,李秋红,白静,等.全冠与嵌体修复对牙周组织的影响研究[J].口腔医学研究,2017,33(10):1086-1090.
[14]仵楠,代海涛,徐江,等.牙周牙髓联合病变激光与药物辅助治疗观察及菌群分析[J].口腔医学研究,2017,33(8):865-869.
[15]Abbott PV,Salgado JC.Strategies for the endodontic management of concurrent endodontic and periodontal diseases[J].Aust Dent J,2010,54(S1):S70-S85.
[2]生安菊,乔秀秀,彭凤梅.188例中老年慢性牙周炎患者牙槽骨吸收情况及危险因素分析[J].临床口腔医学杂志,2016,32(10),606-609.
[3]王岩莉,杨名辉,赵静,等.牙周源性牙周牙髓联合病变病原菌感染与相关性研究[J].中华医院感染学杂志,2016,26(12):2819-2821.
[4]周伟,陈斌,赵俊杰,等.牙周牙髓联合病变牙周治疗时机选择研究[J].口腔医学研究,2016,32(6):601-604.
[5]谭葆春,钟泉,闫福华.重度牙周炎的牙髓治疗研究进展[J].中国实用口腔科杂志,2016,9(4):205-208.
[6]金玥,陈斌,泥艳红,等.牙周来源的牙周牙髓联合病变和牙周牙髓共存病变患牙牙周治疗时机的系统评价[J].华西口腔医学杂志,2018,36(2):167-173.
[7]冯向辉,徐莉,张清.重度牙周牙髓联合病变患牙多学科综合治疗十年疗效观察[J].中华口腔医学杂志,2016,51(7):437-441.
[8]Gary C.Armitage,侯建霞.牙周疾病和状况的诊断及分类系统所面临的挑战[J].中华口腔医学杂志,2008,43(5):260-263.
[9]Zehnder M,Gold SI,Hasselgren G.Pathologic interactions in pulpal and periodontal tissues[J].J Clin Periodontol,2010,29(8):663-671.
[10]Gautam S,Galgali SR,Sheethal HS,et al.Pulpal changes associated with advanced periodontal disease:a histopathological study[J].J Oral Maxillofac Pathol,2017,21(1):58-63.
[11]马先庆.根管治疗后继发根尖周炎患者根管内微生物群落的研究[J].医学临床研究,2016,33(3):485-487.
[12]邱小玲,贾搏,韩久松,等.显微根尖手术联合MTA治疗难治性慢性根尖周炎的研究[J].口腔医学研究,2017,33(7):770-773.
[13]王傲晨,李秋红,白静,等.全冠与嵌体修复对牙周组织的影响研究[J].口腔医学研究,2017,33(10):1086-1090.
[14]仵楠,代海涛,徐江,等.牙周牙髓联合病变激光与药物辅助治疗观察及菌群分析[J].口腔医学研究,2017,33(8):865-869.
[15]Abbott PV,Salgado JC.Strategies for the endodontic management of concurrent endodontic and periodontal diseases[J].Aust Dent J,2010,54(S1):S70-S85.